Zhou M, He JJ, Fei SY, Wang TT, Chen WW, Chen CW, Liu J. Effect of different size sphincterotomy combined with large balloon dilatation on long-term recurrence of choledocholithiasis in patients with large common duct stones.
Shijie Huaren Xiaohua Zazhi 2020;
28:1145-1149. [DOI:
10.11569/wcjd.v28.i22.1145]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
Endoscopic sphincterotomy (EST) combined with endoscopic papillary large balloon dilatation (EPLBD) is commonly used in the treatment of large common bile duct stones, but the effect of the size of sphincterotomy on long-term bile duct stone recurrence has not been evaluated. This study analyzed the difference in curative effects of different size EST combined with EPLBD and its influence on the long-term recurrence of bile duct stones.
AIM
To observe the curative effect of different size EST combined with EPLBD in the treatment of large common bile duct stones, and analyze its influence on the long-term recurrence of bile duct stones.
METHODS
A total of 168 patients with large common bile duct stones were included in this study and divided into three groups according to the size of sphincterotomy: Small incision group (≤ 5 mm), middle incision group (6-9 mm), and large incision group (≥ 10 mm). All the three groups also underwent EPLBD. The main indexes observed and compared in each group were postoperative pancreatitis, bleeding, perforation, cholangitis, and other complications, as well as success rate of stone removal, stone residual rate, and long-term stone recurrence rate.
RESULTS
There was no significant difference in the success rate of stone removal among the three groups (P > 0.05). Postoperative complications such as pancreatitis, bleeding, perforation, and cholangitis were not significantly different among the three groups (P > 0.05).The stone residual rate in the large incision group was lower than those of the other two groups (P > 0.05). The long-term stone recurrence rate in the small incision group was significantly lower than those of the other two groups (P < 0.05).
CONCLUSION
During the endoscopic treatment of large common bile duct stones, smaller papillary sphincter incision combined with EPLBD is helpful to protect the function of the papilla and reduce long-term stone recurrence while achieving the same stone removal effect.
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